Wellcare Sunshine Health Dual Align (HMO D-SNP)

Wellcare Sunshine Health Dual Align (HMO D-SNP) is a HMO D-SNP plan offered by Sunshine State Health Plan, Inc. available for the 2026 plan year to people living in Select counties in FL. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Wellcare Sunshine Health Dual Align (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Wellcare Sunshine Health Dual Align (HMO D-SNP).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Wellcare Sunshine Health Dual Align (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 6 select care drugs, you will pay no copay regardless of whether you use a preferred pharmacy, standard pharmacy, or mail order. Tier 1 preferred generic drugs are highly affordable, costing as little as a $1 copay for a one-month supply at preferred pharmacies, or no copay for a three-month supply through preferred mail order. Tier 2 generic drugs also offer no copay for a three-month preferred mail order, while Tier 3 preferred brand drugs require a 20% coinsurance across all pharmacy options. Non-preferred drugs in Tier 4 carry a $100 copay for a one-month supply, and Tier 5 specialty drugs require a 25% coinsurance for a one-month supply. This structure helps you choose the most cost-effective pharmacy and mail-order options to manage your prescription costs.

Additional Benefits

The Wellcare Sunshine Health Dual Align (HMO D-SNP) offers comprehensive medical coverage with a focus on affordable out-of-pocket costs. For inpatient stays, members pay a flat copayment of $2,225 for acute care or $2,080 for psychiatric care per admission, both with no coinsurance. Most outpatient services, specialist visits, diagnostic tests, and medical equipment require no copay and a standard 20% coinsurance, while primary care visits and home health services feature no copay and no coinsurance. This plan also provides valuable supplemental benefits to support overall wellness, including preventive dental, annual physicals, and fitness programs with no copay and no coinsurance. Additionally, members can access routine vision and hearing benefits, which include allowances for eyewear and prescription hearing aids with no copay, alongside up to 36 free one-way transportation trips per year to approved locations. Over-the-counter items and chronic illness meals are also fully covered with no copay and no coinsurance.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.